Wednesday, July 18, 2012

Qsymia approved for Weight Loss. Here are some helpful tips!

The FDA has recently approved Qsymia for weight loss. It is a combination medication previously called Qnexa. The combination of medication is that of Phentermine and Topiramate. It is designed to decrease hunger in patients while simultaneously help with binge eating urges.

We will be using this on a case by case basis, but with some serious caveats.

The medication has been shown to be helpful in losing weight and burning fat first! But there are some precautions that need to be taken with this medication most notably the risk of birth defects. VIVUS has a healthcare provider information letter that all doctors looking to use this medication should read here!

If a patient has not lost at least 3% of baseline body weight on Qsymia 7.5 mg/46 mg, discontinue Qsymia or escalate the dose as directed, as it is unlikely that the patient will achieve and sustain clinically meaningful weight loss at the Qysmia 7.5 mg/46 mg dose.

ALL women, except those who have gone through menopause or undergone surgical sterilization, should be advised to consistently use effective contraception, even women who have had difficulty getting pregnant in the past.

It is important to have this conversation with all patients. It is important to know whether a patient is:

  • Trying to get pregnant and not using contraception, in which case do not prescribe Qsymia
  • Sexually active and what contraception she is using, in which case reinforce the importance of consistent use of effective contraception
  • Surgically sterilized or has gone through menopause that has been clinically confirmed, in which case no contraception is required

It is important to have this conversation with all patients, so that if there is a female of reproductive potential in the house, the patient knows to keep Qsymia in a secure location and not share it with anyone else.

If a woman believes she might be pregnant, she should stop taking Qsymia immediately and contact her healthcare provider.

Dispensing by certified mail order pharmacies
Qsymia is available only through certified mail order pharmacies that provide a Qsymia Medication Guide and Risk of Birth Defects with Qsymia patient brochure with every prescription and refill as required by the REMS. The list of certified mail order pharmacies can be found at

Reporting adverse events
Healthcare providers should report all suspected adverse events associated with the use of Qsymia. If you become aware of a patient experiencing an adverse event while taking Qsymia, please contact VIVUS Medical Information at 1-888-998-4887 or the FDA at 1-800-FDA-1088 or

If you have any questions you can always come in the office or call

Friday, May 18, 2012

Pregnant Mommy Diet builds a Better Baby

Today I want to write about some exciting studies coming out. The most notable is the idea that caloric control in a pregnant mother will "Build a Better Baby".

Is this true? Is that bundle of joy really made up of what mommy eats whilst bambina or bambino is in the womb? Through simple animal studies and even human studies, we know this to be true. Food and the chemicals that are in what we eat tend to make subtle changes to mommy AND baby's DNA. The building blocks of life.

Think of DNA like a blueprint of a house. The architect drew this wonderful house, which the builders will use to construct the house. Well, how many of you have built a house? It never goes as smoothly as the drawing would depict. Why? The builders are subjected to the elements of the environment. Rain, Hail, Winds, Snow.

Think of your body the same way. By introducing environmental changes, you can alter or slow down who you are really meant to be. This also holds true when you are building another human being inside of you.

So, it comes as now surprise to me, when we find out, prenatal diet matters. In this Meta Analysis (a compilation of studies) they discover dietary modification reduces risk of Pre Eclampsia and gestational diabetes. Surprisingly, exercise does not have the same effect.

You heard that right. Only diet in this study was shown to reduce risk of complications. The good news is, we can help with this. Weight gain control and dietary modification is the key and we excel at this!

The next study shows that maternal diet can cause obesity and metabolic syndrome in children. How? Through a set of chemical changes called epigenetics. Think of epigenetics as the sleet, rain, hail and wind of your home building. As you know, these environmental forces can have a devastating effect on your home. So too can epigenetic changes affect the way your are born and the diseases you may get.

The goal of diet is to have the right amount of protein, carbohydrates and fats. Ultimately that is the plan.

At Murphy Medical Weight Loss Programs, we can help plan a diet that will help you minimize weight gain during pregnancy and also feed you all the right nutrients to keep your "Forces of Nature" at bay!

Saturday, April 21, 2012

Surgery beats Diabetes Medications in Diabesity and Diabetes

I would like to take the next few minutes to review what I see as a grave misrepresentation. You see, I treat patients who want to lose weight. I see patients for weight loss daily. Unfortunately, some of these patients are obese and a growing number are what we call morbidly obese.

It is in this morbidly obese group that I am making more and more diagnoses of diabetes. Other doctors have not told them about this diagnosis, because we have been using imprecise measures in general medicine to diagnose diabetes. By using imprecise tools, we have been missing the diagnosis.

Why does this matter? Because this epidemic of diabetes in the obese is UNDER-DIAGNOSED and what I am about to tell you will apply to many more patients in the next 5 years.

But first the misrepresentation.

The popular media has been covering a study in Italy which looked at a grand total of just 60 patients. Correct, JUST 60 patients. But the "news" is hailing it as a great study. Scientifically, this is a very, very small number of individuals. But results of surgery were fantastic and reflect what has always been known in the weight loss community.

If the patient gets diabetes from being overweight, treating the diabetes without getting the patient to lose weight is a fool's errand. You have to lose weight. This study is not revolutionary. It is not HUGE news!

That is the misrepresentation. Here is the straight scoop. By shrinking the fat mass on a patient, you improve insulin sensitivity and can remove medications and CURE Diabetes. As the study indicated. If you drop your BMI from 41.3 to 28 you can cure Diabetes 80% of the time, in this group of 30 patients.

How much diabetes do you cure with medications? ZERO. No patients with diabetes were cured with medications that are used to treat diabetes. This is no surprise as almost all diabetes medications cause weight gain or no weight loss. You need to lose weight to cure diabetes.

Does this means I as a non-Surgical weight loss doctor cannot cure diabetes? No.

I Cure Diabetes Daily with weight loss medications and diet! Put simply, I can cure diabetes without surgery.
That is HUGE news and I am blown away the media isn't covering this. The grave misrepresentation is that SURGERY ALONE AND NOT MEDICATION can cure diabetes. Doctors who cure obesity also cure diabetes. The treatments are the EXACT same.

Monday, April 16, 2012

K-E Diet. Here comes the bride, with a feeding tube

I have thought that I have heard everything regarding weight loss. But, simply, I am blown away by the level of desperation in these poor brides.

What are wives-to-be doing to lose weight before the big day? They are getting feeding tubes inserted in their noses and sent to their stomachs. These tubes are used to deliver food via a pump which is kept in their handbag.

The pressure to lose weight prior to a wedding has driven many people to a diet plan which has been around in Europe for some time. This diet is called the K E diet. It is offered by a physician in Florida and I wonder if many more will follow.

What are the risks of a very low calorie diet. Simple.

1. Dehydration-starting a low calorie diet requires enough water to offset the increased urination
2. Electrolyte abnormalities-If the tube feed does not meet those requirements, you can get a problem with the chemicals in your blood stream which can cause a host of other problems
3. Feeding tubes over longer than 4 days can increase your risk of infection in your sinus cavities
4. Nausea, stomach upset, acid reflux of stomach.

Why try this diet? Supposedly according to the physician doing this in Florida, it is more successful at suppressing hunger than regular eating due to continuous feeding.

I would like to see a head to head trial on this because, I don't see how very low calorie diets would differ that much in orexigenic properties.

In a nutshell, I would avoid this diet and instead save the 1500 USD for a proven medical weight loss program. Our program costs WAY Less than 1500 USD and can help you lose this much weight loss and even more.

Photo Courtesy: ABC News

Saturday, March 31, 2012

60 Minutes about to Blast the Sugar Industry! I am excited.

It appears that what the American Society of Bariatric Physicians has been saying is finally getting some press.

Tomorrow night 60 Minutes will be covering the risks of sugar in the diet. This year in Circulation, a key journal for heart doctors and weight loss doctors like myself, it was proven that sugar sweetened beverages increase risk of heart disease and risk markers.

In fact, your cholesterol, your levels of inflammation, your weight all go up with sugar sweetened beverages.

It was just 7 months ago when I lost nearly 30 pounds by burning fat first and knowing what's in my tank. But the most important thing I did was to research and train in bariatric medicine. What is crystal clear according to food researchers and my education is this.

Fat is not the enemy, Sugar is the enemy.

Now the media is covering it. You see, the real enemy is Insulin a hormone produced normally in little amounts at baseline. The real problem is when we cause our bodies to secrete large amounts of insulin. Insulin elevation has also been linked to inflammation, elevated fat in our blood stream and fat in our livers.

Worse than that is the fact that Insulin prevents your body from ever burning fat as an energy source. Insulin suppreses a chemical reaction called lipolysis. Lipolysis is responsible for burning fat as an energy source. This prevention leads to a significant craving of carbohydrates to fuel the human machine.

Sugar in small amounts is ok. Sugar added to Skim Milk? That's not ok and the industry needs to stop doing it. Immediately. For the love of the kids and the adults with obesity, heart disease and cancer everywhere!

Sunday, March 25, 2012

Is a calorie just a calorie? 3 philosophies for smart diet choices

I was reading an op-ed in the NYT where the reporter interviews 2 food researchers who answer the age old question. "Is a calorie just a calorie?"

Well, at our weight loss program we have 2 views on this. They stem from 3 fundamental philosophies.

The First Philosophy: You can never keep weight off if you don't now how many gallons your fuel tank holds.

Meaning: If you don't know how many calories your body needs in a day, you are likely to overfill yourself calorically.

Why? We live in a non-filling food paradise where everything has too many calories and too many sugars.

The Second Philosophy: Once you are overfilled with calories, the fat on your body is the problem, not the weight.

Meaning: When you want to lose weight, the chemical secreted by fat make you hungry and make it tougher to lose weight.

Why? There are over 100 chemical secreted by fat cells and only 2 of them are salubrious.

The Third Philosophy: A little hunger is a good thing, a lot of hunger is a dangerous thing.

Meaning: Being overly hungry could mean you are dehydrated or not eating enough to feed your machine, resulting in lean muscle mass breakdown. Or worse, you are spiking insulin levels and your blood sugar is all over the place.

Why? Too much hunger makes us reach for quick fixes like carbs, resulting in the same cycle of hunger all over again. We chose lean protein over carbs because they fill us up. Similarly, high fiber veggies work nicely too.

So here's the deal. A calorie is just a calorie if you don't feed yourself too many of them. When you feed yourself too many calories carbohydrates are far more dangerous for you than just about anything.

Dangerous how? By causing diabetes, inflammation, heart disease and god knows what else.

So when looking at calories:

1. Know how many you need. You can do that by checking a resting metabolic rate Don't use a calculator they are almost always off. Do the testing!

2. Chose calories that will fill you up and reduce your hunger. In those cases, chose lean protein and high fiber calories.

3. If you have to overfill your tank, chose calories that won't cause the yo-yo of insulin and blood sugar.

So is a calorie a calorie? It depends.......But often the answer is No!

Monday, March 19, 2012

Botox and Juvederm in Greenwich Office. Dr Gamble.

I am very excited to let everyone know that Doctor Sarah Gamble will be joining practices with us. She will bring her aesthetic medicine specialty as well as her skills with plant based nutrition. Now you will be able to receive Juvederm, Botox, Radiesse and other treatments in our practices in Greenwich CT!

Yes, now not only weight loss, but also aesthetic medicine in our Greenwich Offices! 115 East Putnam Greenwich CT.

Sunday, March 18, 2012

How to Integrate Weight Loss in a Medical Practice

I just want to take a few moments to tell you about Take Shape for Life.

Have you heard of it? I was amazed when at a Bariatric training conference this weekend, no one had heard of it. Yet at this same conference there were bundles of physicians who wanted to integrate weight loss into their practices. Most had no clue how to do it!

Here are the top 5 reasons why Take Shape for Life is great to integrate in your practice

1. It is a program for life. With behavioral components, it can really sustain weight loss and healthy living.

2. You do not have to carry inventory, yet still make profit from your meal replacement.

3. Patients succeed with the 5 and 1 program. Patients will always refer others if your plan works!

4. By utilizing the program training from this company, you can easily train your staff to become coaches!

5. Unlike franchises such as Centers for Medical Weight loss, you don't need to pay 15,000 USD to start!

I wish I had found Take Shape for Life first

If you are doctor looking to integrate weight loss into your practice, email me and check out the website

If you are a patient and want to lose weight, check out my site.

Best of health!

Sunday, March 11, 2012

Medical Weight Loss is Tax Deductible!

Did you know that this year if you enroll in a medical weight loss program you can have those expenses tax free.

Caveat: I am not an accountant or CPA. Every case is different and you should consult your accountant PRIOR to filing taxes! But

Yes, what I said is correct. You can get a tax deduction for a medical weight loss program. Don't believe me? Here is what the IRS has to say about it! 

What is covered?
1. Electronic body scans. If your insurance doesn't cover body composition testing and you paid, then it is tax deductible
2. BP Monitors. If your weight loss program has asked you to buy and monitor your BP. This too is tax deductible. As is a Heart Rate monitor!
3. Lab testing. If you had lab testing not covered by insurance, it too is tax deductible!
4. Off Site Medical Retreats. If your weight loss program has an offsite or resort where they take you, you can deduct food and lodging if you received medical care there!
5. If your archaic insurance company doesn't cover weight loss and you had to pay out of pocket for the program, you can claim a tax deduction!
6. For my patients who pay for VO2Max testing and RMR testing. That is also tax deductible!

What is not covered?

The IRS Publication 502 lays out specifically what is NOT covered. You should review that closely.

Again, this is only a rule of thumb. You need to double check with your accountant. But as I read it, medical weight loss is tax deductible!

Keep Burning Fat First!
-Dr. Murphy

Saturday, February 18, 2012

Phentermine. What is it? Does it work?

I am often asked by patients and peers about a medication called Phentermine. Many people assume that this is the "Bad Fen" in FenPhen.

Well, it is not. It actually is the "Good Phen". So that's the first thing I tell them. The second thing I tell them, "It works"

Phentermine is the first line "anorectic (appetite suppressant)" for obesity treatment. It has a long half life of 18-24 hours, which means it stick around in your body and that you only need to take once or twice a day.

The starting dose of the medication is often a half tablet of 37.5mg of phentermine.

Phentermine has a few very good effects

1. The immediate effect of reducing hunger by acting in the brain at the periventricular nucleus

2. The second is an effect longer term on eating restraint. Which lasts during treatment.

3. The third and more long term effect of controlling carbohydrate cravings. Some but not all feel this.

Who can't take phentermine?
1. People who are pregnant.
2. People who are nursing an infant.
3. People with a rare allergy to phentermine.

You should always take the medication under the supervision of a physician. In other words, online ordering of Adipex-P should be avoided unless instructed by a physician!

This is because, like all medications, there are adverse effects. These include:
1. Palpitations, skipped heart beats
2. Insomnia, rare but does happen <3%
3. Irritability, can happen as well
4. Rare cases of dry mouth 1 in 1000
5. others not listed but very rare like Bladder spasm, migraine HA

So the take away is this.
See your doctor if you are having difficulty losing weight. The "Good" Phen may be what the doctor orders!

Friday, February 17, 2012

Arsenic in Infant Formula and Energy Bars!

Have you ever heard of brown rice syrup? I have. It is an ingredient food manufacturers use instead of high fructose corn syrup.

People have actually been flocking to this, especially as we learn more about the problems of high fructose corn syrup and obesity. The big problem is that the FDA is overwhelmed with all sorts of new derivative of food products and has not had the time to fully review this brown rice syrup.

An independent reviewer did review the levels of arsenic in organic baby food and found unacceptable levels. Up to six times what is considered safe in drinking water. Further, babies are small and get hit with more.

At  Adriana Vega asks "Which Ones?" Good question, the researchers did not release this info.

What matters to me is that certain diet fads like the "Alkaline diet" may move dieters towards Brown Rice Syrup as a sweetener. Further, Vegans and Celiac patients of mine use this sweetener.

I am now steering all of them clear of this substance as we can't be sure how much is enough to avoid the arsenic toxicity.

The Take Away: Steer clear of Brown Rice Syrup! You don't want to risk arsenic toxicity.

Thursday, February 16, 2012

Automatic shut off gas pumps and childhood obesity!

I just cannot get over how many people do not understand what they need to eat daily. We teach in school this broad based sweeping generalization of what a good diet needs to be and how many kcals a person needs in a day. Most of this information is dead wrong.

So, in a susceptible patient, why would we expect anything OTHER THAN obesity?

I explain it this way. Ask a kid today what happens when they pump gas.
"I just press the pump and when it's full, it shuts off"

Ask a 70 year old man what happened 40 years ago when the pumped gas
" It got on your shoes if you overfilled the tank"

We have no shoes! Further, we have no spray warning.

How can we expect today's youth to understand and learn how to stay lean and fit? We cannot. This is especially true for an increasingly sedentary population that needs less calories than their predecessors

So here's my pitch. Put metabolic testing equipment in gym class. Make it a fusion class of health and gym.

Give every student their very own tank. Teach them how many kcals they need. Maybe by just telling them what's in the tank, they will make better choices with food.

Whaddya First Lady Michelle Obama? Sound like a plan

Sunday, February 5, 2012

SuperBowl Plan to minimize the overeating damage.

3 hours before kickoff. Headed to the party in 30 minutes. What can you do to plan now?

The answer is simple to keep the weight off.

1. Don't drink your calories-Pick Light Beer if you are drinking (for those over 21 yrs old), No Soda!!!!
2. Stay away from high carb foods like pretzels and chips.
3. You won't have time to plan for calorie counts, but you can download a calorie app in seconds now to track
4. Avoid Sugar at all costs.....stay away from sweets and cookies or cakes.

If you do these four things, you will fare ok. And if you go over your calorie count, remember, you can use activity and exercise as a currency to buy back all those calories you consumed.

What is the best way to lose weight? Have a plan, get support and Burn Fat First!!!

You can do it. And if you are in Fairfield County CT or Westchester County NY you can do it with us at Murphy Medical Weight Loss Programs! Give us a call at 203-869-0451.

Monday, January 30, 2012

Overweight Doctors Can't Do Weight Management?

Is it true? Well, it is all over the news! Physicians with a normal BMI are more likely to bring up weight loss and management to patients. At least according to a recent study in the Journal Obesity.

Well, I would pick an overweight Obesity Specialist over a normal weight Internist any day. Why? Most primary care doctors know absolutely nothing about weight loss. They know so little it is scary. In fact one medical weight loss franchise owner says "I learned more about malaria than obesity in medical school. I have yet to see one case of malaria."

He's right. That being said the study said normal weight physicians felt more confidence in their ability to counsel on diet and exercise. What I didn't find is whether the advice given was correct or not.

Put simply, when I lost weight using my specialized program I did gain confidence. By receiving education in bariatric medicine, I gained much more. More importantly I learned what works and what doesn't.

So is your physician overweight or obese? How are the managing your weight loss? Are you satisfied with your results?

Again, the true way to lose weight is to burn fat first. Plain and simple. Once you burn the fat, the weight is easy to take off!

Sunday, January 29, 2012

Are you not satisfied with your weight loss results?

I find that the end of January is always a tell tale sign for those patients who have been trying at home and online weight loss programs. We see many people disappointed with their results. These are various reasons for failure to progress.

With most of the non medically guided services I find some very good things. The first of these are support. Programs like Jenny Craig offer a weekly phone call and check in. This is very nice and useful. We find support program do help patients lose weight.

Here's what often leads to failure to lose weight.
1. Medical issues such as sleep apnea and no treatment. Sleep disturbance affects weight loss.
2. Medical issues such as endocrinopathy of adiposity
3. Lack of protein and macronutrients for nutritional ketosis and lean muscle support

Have you figured it out yet?

If you want to succeed partner with a physician. We have all sorts of strategies to help you lose weight. Further, you may need medical management to enhance further weight loss!

Friday, January 27, 2012

Weight Loss and Body Composition Testing!

Today we had a great day in the office. Why? We burned hundreds of pounds of fat. The best part of this is that we got to see a bunch of very happy faces.

In fact, patients who didn't lose exactly as much weight as they wanted, ultimately found out based on body composition testing, that they were burning fat and putting on lean muscle mass!

If you are not getting body composition testing, you are missing out. Often I find when people are trying over the counter weight loss programs, they get disappointed when they don't lose weight as fast as they would like. Well, it turns out, they may actually be doing much much better than what their weight shows.

Body composition is a much needed testing point for weight loss. It is important to do this for 3 reasons!

1. I want to see how well we are burning fat. If we level off, I want to ramp it up.
2. I want to make certain we do not miss a loss of lean body mass. We will increase protein then.
3. When patients don't lose so much weight, they could be actually be losing quite a bit of fat!

So, the teaching point is simple. If you are in a weight loss program, you should be getting body composition testing at least monthly.

Wednesday, January 25, 2012

Why protein matters in low calorie diets

From Healthwise. Why you should avoid Carbs and Eat More Protein!

The importance of protein within the context of low calorie diet cannot be underestimated. The use of
supplemental protein in the diet has several important functions.

Protein plays a major role in the structure and function of the body. It is an important structural
component of cells, hair and nails. It is an integral part of skin, bones, muscles, blood and connective

Without adequate protein, our immune systems wouldn’t function properly and our bodies would have difficulty producing adequate hormone levels. In fact, every metabolic function that occurs in the
body depends upon the presence of proteins called enzymes.

Even when not dieting, the proteins that make up our muscles are constantly being turned over. As
our caloric intake decreases, the body will begin using these proteins from our muscles to meet its
energy needs. Ideally, during dieting, the goal is not just weight loss, but rather fat loss and muscle
maintenance or gain.

For this to occur, our overall caloric intake must decrease while maintaining
adequate protein consumption. As muscle mass increases, so does one’s resting metabolic rate. This,
in turn, allows the body to burn more calories during rest, regular activities of daily living and with
exercise. Another benefit to a proportional increase in dietary protein is the increased satiety it provides.

Gram for gram, protein tends to satisfy and decrease hunger better than either fats or
carbohydrates. This helps improve a dieter’s chances of success by reducing the chronic hunger
that so often comes with calorie reduction.

Recommended amounts of protein vary depending upon one’s age, gender and current fitness and
activity levels. The suggested range begins at 0.8 grams of protein per kilogram of lean body weight
per day to upwards of 1-1.5 grams per kilogram of lean body weight for the very seasoned and muscular athletes.

As one begins dieting, a positive nitrogen balance can easily be maintained with the addition
of supplemental protein in the form of protein bars or protein supplements. This is a very good way to
ensure adequate protein while keeping total calories low.

In the context of an LCD diet or protein sparing modified fast, the reduction of carbohydrates has
equally important consequences. The hormonal changes associated with low carbohydrate diet include
a reduction in the circulating levels of insulin along with increased levels of glucagon. Insulin has
many actions, the most well-known of which is stimulation of glucose and amino acid uptake from
the blood to various tissues. This is coupled with stimulation of anabolic processes such as protein,
glycogen and fat synthesis.

Glucagon has opposing effects, causing the release of glucose from glycogen
and stimulation of gluconeogenesis and fat mobilization. Thus, the net stimulus would seem to be for
increasing muscle protein breakdown. However, a number of studies indicate that a low carb diet results in body composition changes that favor loss of fat mass and preservation in muscle mass.

According to G.L Blackburn's study carbohydrate apparently does not improve protein sparing. In
studies have shown that obese patients on a diet containing 40 grams of protein experienced
significantly better nitrogen balance than patients on an isocaloric diet in which 26 grams of
carbohydrate replaced some of the protein.

There is another theoretical advantage to omitting carbohydrate from a very low calorie diet. If a diet contains the minimum amount of protein needed to prevent loss of lean body mass, addition of carbohydrate adds calories and will therefore decrease the rate of weight loss.

In a recent randomized trial in 17 healthy obese women, a diet containing 1.5 gm
protein/kg ideal body weight was found to result in significantly better protein sparing than an isocaloric
diet providing only .8 gm protein/kg ideal bodyweight.' Patients lost weight at the same rate on the two
diets, but since there was less nitrogen loss on the diet without carbohydrate, it can be assumed that
more fat loss occurred than on the diet where carbohydrate replaced some of the protein.

What implications does this have regarding the choice of the protein supplements mentioned in the
protein discussion? It means that for the benefit of both the health and success of the dieter, the selection
of protein supplements should focus not only on the taste but on the nutritional composition of the

The best choice is to avoid higher carbohydrate, low protein supplements and to select
supplements that are higher in protein and lower in carbohydrate content. The conclusion would be
that for products that are relatively similar in carbohydrate content, the preferred choice would be the
protein supplement that offers a higher protein content and a taste that the patient find both pleasing and

Sunday, January 22, 2012

Phentermine Works! But see the MD!

There are a whole lot of people online who are searching high and far on the internet to get a prescription for phentermine. My advice? Go to a medically run weight loss program. Why?

Phentermine requires some monitoring.

Recently I saw a patient who was on Phentermine and Topiramate (a super common combination) for weight loss. When I asked how she got these, she sheepishly acknowledged that she had gotten these on the internet.

I then asked her if she had side effects, she said, "yes palpitations". I asked if she had a baseline EKG when starting the medication, she said no. We did one immediately!

Listen, I understand, there are a whole lot of doctors who poo poo weight loss medications. They are wrong and this could be dangerous. Why? Because it can drive patients to the internet for "no RX needed phentermine"

So, if you have been poo poo'd, fear not. There are doctors out there, who, if they think it will benefit you, will prescribe phentermine. Ideally make sure they are part of the American Society of Bariatric Physicians. Why would we prescribe it? Because it works! Alongside a great medical program you can achieve maximum appropriate weight loss.

There are side effects to this medication and they should be monitored by a physician who understands the medication. And remember, that internet site has not taken a hippocratic oath to first do no harm.

If you are in the Greater NYC area, call us!

What's in your tank? Why Burn Fat First?

Last year I set out on an adventure. You see, I was overweight. In BMI circles, I was bordering on obese. I discovered something amazing. Sure, I had lost weight before my wedding. I tried weight watchers, which allowed me to lose some weight and man did I look good at my wedding! But after the wedding, I put the weight back on.

Then after my first child and the daddy sympathy weight, I put on more. Then I launched my medical practice and put on more.......

You get the story.

So, about my discovery.

I found out what was in my tank and how to burn fat first. Using this knowledge I lost 20 pounds and have kept it off! To get an idea, 20 pounds was 10% of my body weight! For some of you, 10% is 30 or 40 pounds. Could I have lost more? Absolutely.

Did I need medications or nutritional supplements? No. But for many these help. Especially Phentermine and phendimetrazine. We use these at my weight loss clinic.

Did I need a meal replacement program? No. But for many it helps them keep it off! We use this at my weight loss clinic too.

Imagine if you went to pump gas and didn't have a gas gauge. You had no clue how much gas was going into the car. You would have no way to know if your car was full. Further, the only way you could stop is when the gas was pouring all over your nice new shoes.....

That doesn't happen right? Correct, some smart engineer created gas gauges. Then after too many people had their feet wet with gas, they then created automatic ctop switches for pumps. The pump stops pumping for you when the tank is full. That is exactly the problem with our bodies. There is no gas gauge and their is no automatic kill switch for our pump.

The problem with most weight loss programs and with online diet companies is that their technology and science is stuck in the model-T version of weight loss. Cut your calories and you will lose weight.

Well, it is much more scientific and medical than that. What you need is a 21st Century team.

I learned what was in my tank and then created the "Virgin Galactic" version of weight loss.

What's the first 2 steps of this dance?

1. Find out what is in Your Tank.
Everyone is different here. Believe it or not. Your tank size is NOT PRECISELY RELATED to your body size. You can try and estimate using equations. But unless you undergo technologically advanced medical metabolic testing using gas exchange, you will never know "What's in your Tank"

2. Burn Fat First
There were many times when I looked at my fat and was upset, then I came to view it as my friend. Accepting it as a part of me. Well, it IS NOT a part of me. It is a parasite sabotaging you, making you hungry, slowing weight loss. If you don't Burn Fat First, you will never lose weight long term. Further, you never reap the benefit of health if you don't burn fat first.

Over the course of this blog I will share weight loss tips, weight loss secrets and weight loss analysis. If you stick with me I will, in essence, walk you through our weight loss program. Unlike secret medical weight loss franchises that hide their "special sauce" or have fly by night felons in charge,  I will put it all out here on the internet, free to those who read along.

Come along for the ride, we are gonna have some fun helping you lose weight!